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Published on: September 19, 2019
Development and validation of the distress thermometer for parents of a chronically ill child
Lotte Haverman1, Hedy A van Oers, Perrine F Limperg
1Psychosocial Department, Academic Medical Center/Emma Children's Hospital, Amsterdam, The Netherlands.
Insights
A new tool, the Distress Thermometer for Parents (DT-P), effectively screens for parental distress in caregivers of chronically ill children. A cutoff score of 4 on the DT-P accurately identifies parents needing support.
Area of Science:
- Pediatric Psychology
- Clinical Psychology
- Family Medicine
Background:
- Parental distress is a significant concern in families with chronically ill children.
- Existing screening tools may not adequately capture the multifaceted nature of parental distress.
- Early identification of parental distress is crucial for effective intervention and improved child health outcomes.
Purpose of the Study:
- To develop and validate the Distress Thermometer for Parents (DT-P) as a screening tool.
- To establish a reliable cutoff score for identifying clinical levels of parental distress.
- To assess the DT-P's utility in a large, diverse sample of parents.
Main Methods:
- The Distress Thermometer for Parents (DT-P) was developed, incorporating a 0-10 distress score and a problem checklist across six domains.
- Validation involved correlating DT-P scores with the Hospital Anxiety and Depression Scale (HADS) and the Parenting Stress Index.
- 706 parents of chronically ill children (aged 0-18) participated in the study.
Main Results:
- The mean DT-P score was 3.7 (SD 3.0).
- DT-P scores showed strong correlations with anxiety and depression (HADS) and moderate-to-strong correlations with parenting stress.
- A cutoff score of 4 demonstrated 86% sensitivity and 67% specificity in identifying clinically distressed parents based on HADS scores.
Conclusions:
- The Distress Thermometer for Parents (DT-P) is a valid and practical screening instrument.
- The DT-P effectively identifies parental distress in caregivers of chronically ill children.
- The established cutoff score enhances the clinical utility of the DT-P for targeted support.
Objective:
To develop and validate a Distress Thermometer for Parents (DT-P) for chronically ill children and to determine a cutoff score for clinical distress.
Study Design:
Parents of a chronically ill child (0-18 years) were recruited via announcements or were actively approached at the outpatient clinics of the Emma Children's Hospital/Academic Medical Center and Vrije Universiteit Medical Center. We modeled the development of the DT-P on the Distress Thermometer used in oncology medical care. The DT-P consists of a thermometer score from 0 (no distress) to 10 (extreme distress) and a problem list (practical, social, emotional, physical, cognitive, and parenting domains). The DT-P was validated with the Hospital Anxiety and Depression Scale (HADS) and the Parenting Stress Index.
Results:
The mean thermometer score of the 706 participating parents was 3.7 (SD 3.0). The thermometer score and the scores in the practical, emotional, physical, and cognitive problem domains were strongly related to anxiety, depression, and the total score of the HADS (0.55 ≤ r ≤ 0.72). The thermometer score and all problem domain scores were moderately-to-strongly related to the Parenting Stress Index (0.38 ≤ r ≤ 0.63). A cutoff-score of 4 correctly identified 86% of "clinical HADS cases" (sensitivity) and 67% of "nonclinical HADS cases" (specificity).
Conclusions:
We developed the DT-P and examined its diagnostic utility in a large sample. The DT-P appeared to be a valid and useful short screening-tool for identifying parental distress.
